Isabel Diaz Tinoco (L) and Jose Luis Tinoco speak with Otto Hernandez, an insurance agent from Sunshine Life and Health Advisors, as they shop for insurance under the Affordable Care Act at a store setup in the Mall of Americas on November 1, 2017 in Miami, Florida. (Photo by Joe Raedle/Getty Images)

Health insurance companies that stuck with providing individual coverage under the Affordable Care Act will divvy up the spoils next year thanks to departures of rivals Aetna, Anthem, UnitedHealth Group and Humana from key markets.

Nationally, enrollment was ahead of expectations and not far off last year’s total even though the Donald Trump administration cut the sign-up period in half. More than 8.8 million Americans signed up to individual coverage for 2018 via the ACA’s exchanges or slightly below last year’s 9.2 million.

"Given the generally healthy appearance of marketplace enrollment, carriers like Centene who doubled down on serving the subsidized population are probably feeling reassured,” said Katherine Hempstead, who directs the Robert Wood Johnson Foundation’s work on health coverage issues. “For those who count on the off exchange market as well the outlook is a little less clear.”

Centene has yet to release enrollment figures for 2018 but is expected to do well given its major expansion. Centene will enter Kansas, Missouri and Nevada next year and expand in six other states where it already sells individual ACA policies, including markets where Anthem, Aetna and UnitedHealth Group are leaving.

A report in Bloomberg on Centene detailed how the insurer makes a lot of money off of narrow network plans with few providers. Blue Cross and Blue Shield plans have also been narrowing networks in recent years to improve profits.